Individual
CHARLES JOSEPH FAZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 CARLSON PKWY, MEDICA CP433, MINNETONKA, MN 55305-5359
(952) 992-3056
Mailing address
401 CARLSON PKWY, MEDICA CP433, MINNETONKA, MN 55305-5359
(952) 992-3056
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25504
MN
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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